Provider Demographics
NPI:1972921823
Name:HARP, HERMAN (LMP)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:
Last Name:HARP
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 TACOMA MALL BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6901
Mailing Address - Country:US
Mailing Address - Phone:253-682-0220
Mailing Address - Fax:
Practice Address - Street 1:5631 TACOMA MALL BLVD
Practice Address - Street 2:STE 2
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6901
Practice Address - Country:US
Practice Address - Phone:253-682-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60449701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist